Diabetes Treatment Is Associated With Better Cognitive Function: The Age Disparity

Background: Diabetes mellitus (DM) is a recognised risk factor for cognitive dysfunction. The purpose of this study was to explore the relationship between active treatment for DM and cognitive function in middle-aged (< 60 years) and older adults (≥60 years), respectively.Methods: A total of 13,691 participants (58.55 ± 9.64 years, 47.40% of men) from the Chinese Health and Retirement Longitudinal Study (CHARLS) were included. The participants were classified into three groups according to whether or not they have diabetes and to their diabetes treatment status: diabetes-free, treated-diabetes and untreated-diabetes, in which the diabetes-free group was regarded as reference specially. Cognitive function was assessed by two interview-based measurements for mental intactness and episodic memory.Results: Compared with the participants in the diabetes-free group, the older participants in the treated-diabetes group had better performance in terms of mental intactness (β = 0.37, 95% CI = 0.04–0.70). No significant association was observed in the middle-aged participants. In the subgroup analyses, the lower cognitive score was only observed in people without depression, who had never smoked and drunk, and with a normal weight (body mass index: 18.5–23.9 kg/m2).Conclusion: The cognitive function of actively treated diabetic patients was better than that of patients without diabetes, but the improvement was significant only in elderly people. Depression, smoking, drinking, and an abnormal weight may attenuate this effect.

Landmark Cancer Clinical Trials and Real-World Patient Populations: Examining Race and Age Reporting

Background: Concern exists that the clinical trial populations differ from respective cancer populations in terms of their age distribution affecting the generalizability of the results, especially in underrepresented minorities. We hypothesized that the clinical trials that do not report race are likely to suffer from a higher degree of age disparity. Methods: Food and Drug Administration (FDA) drug approvals from July 2007 to June 2019 were reviewed to identify oncology approvals, and trials with age details were selected. The outcomes studied were the weighted mean difference in age between the clinical trial population and real-world population for various cancers, the prevalence of race reporting and association of age and race reporting with each other. Results: Of the 261 trials, race was reported in 223 (85.4%) of the trials, while 38 trials (14.6%) had no mention of race. Race reporting improved minimally over time: 29 (85.3%) in 2007–2010 vs. 49 (80.3%) in 2011–2014 vs. 145 (85.4%) during the period 2015–2019 (p-value = 0.41). Age discrepancy between the clinical trial population and the real-world population was higher for studies that did not report race (mean difference −8.8 years (95% CI −12.6 to −5.0 years)) vs. studies that did report it (mean difference −5.1 years, (95% CI −6.4 to −3.7 years), p-value = 0.04). Conclusion: The study demonstrates that a significant number of clinical trials leading to cancer drug approvals suffer from racial and age disparity when compared to real-world populations, and that the two factors may be interrelated. We recommend continued efforts to recruit diverse populations.

Immune cell residency in the nasal mucosa may partially explain respiratory disease severity across the age range

Previous studies focusing on the age disparity in COVID-19 severity have suggested that younger individuals mount a more robust innate immune response in the nasal mucosa after infection with SARS-CoV-2. However, it is unclear if this reflects increased immune activation or increased immune residence in the nasal mucosa. We hypothesized that immune residency in the nasal mucosa of healthy individuals may differ across the age range. We applied single-cell RNA-sequencing and measured the cellular composition and transcriptional profile of the nasal mucosa in 35 SARS-CoV-2 negative children and adults, ranging in age from 4 months to 65 years. We analyzed in total of ~ 30,000 immune and epithelial cells and found that age and immune cell proportion in the nasal mucosa are inversely correlated, with little evidence for structural changes in the transcriptional state of a given cell type across the age range. Orthogonal validation by epigenome sequencing indicate that it is especially cells of the innate immune system that underlie the age-association. Additionally, we characterize the predominate immune cell type in the nasal mucosa: a resident T cell like population with potent antiviral properties. These results demonstrate fundamental changes in the immune cell makeup of the uninfected nasal mucosa over the lifespan. The resource we generate here is an asset for future studies focusing on respiratory infection and immunization strategies.

Prescription pattern of evidence-based pharmacotherapy in heart failure: An age perspective

Funding Acknowledgements Type of funding sources: None. Background Elderly patients constitute substantial proportion of medical care beneficiaries, in same line; heart failure (HF); an extremely common comorbidity is predominately affecting older patients, yet, age disparity in managing this population still represents remarkable challenge in practice. However, little insight is available regarding adherence to evidence-based pharmacotherapy prescribed for this population in developing countries. Purpose this study sought to investigate age-based differences in clinical profile and pharmacotherapy prescription pattern in patients with HF. Methods This study recruited hospitalized patients with systolic HF, patientsꞌ demographic characteristics, investigational results as well as prescribed drugs in hospital and at discharge; all were recorded. Patients were grouped according to age into ≥65 years versus ˂65 years. Results The study recruited 201 patients, 89 (44.27%) of them at age ≥65 year vs 112 (55.72%) in younger group, mean age of older group was 72.4 ± 7.2 year vs 53.5 ± 8.9 year (p < 0.001), female gender constitutes 39.3% of older group vs 26.8% (p < 0.001), older patients were more to have hypertension (68.5% vs 63.4%, p < 0.001) and AF (19.1% vs 17.9%, p < 0.001) and less to be diabetic than younger counterparts (48.3% vs 54.5%, p < 0.001). IHD was most common cause of HF in both groups (92.1% in older group vs 82.1%), dilated cardiomyopathy caused more HF in younger group (12.5% vs 5.6%). No significant differences between both groups regarding heart rate, blood pressure at presentation nor blood urea, serum creatinine or ejection fraction. However, haemoglobin was lower in older group (12.3 ± 1.8 gm/dL vs 13.5 ± 2.2 gm/dL, p = 0.0001). Older patients were treated less with B-blockers 75.3% vs 79.5% while they were prescribed mineralocorticoid receptor antagonist (MRA) more than younger counterparts (46.1% vs 42.9%, p < 0.001), ACE/ARBs/ARNI were prescribed more in older population (62.9% vs 53.6%, p < 0.001). Among patients with heart failure in general: antiplatelet drugs were prescribed more in older patients 75.3% vs 71.4%, while statins used in 68.5% in elderly vs 69.6% in younger counterparts. However, in the context of HF and IHD, antiplatelet drugs were prescribed less in older patients (81.7% vs 86.95%, p < 0.001) same as statins (74.4% vs 84.8%, p < 0.001). Conclusions This study contradicted prior researches as ACEI/ARBs/ARNI and MRA were used more in older patients with HF compared to younger counterparts. However, there is still significant age disparity revealed in form of less use of B-blockers in elderly same as antiplatelet, statin and oral anticoagulant when indicated. Further studies are warranted to determine the predictors for age gap in practice in order to be bridged to achieve better cardiovascular outcomes. Abstract Figure.

Nutrition planning during the COVID-19 pandemic for aging immunity

The disease COVID-19, caused by the SARS-CoV-2 coronavirus, disproportionately targets individuals with aging or otherwise dysfunctional immunity. Since nutrition is shown to have a massive effect on the immune system—and other body systems that can both improve protection and ability to fight against the SARS-CoV-2 virus—we conducted a literature review of nutrition recommendations and their antiviral effects in older adult populations. Certain bioactive compounds and functional foods have been shown in the past to improve the body’s immune function and prevent viral infection. We organize our recommendations by food groups, as delineated by the MyPlate nutritional program, to create guidelines for senior citizens, public health experts, nutritionists, caretakers, and nursing homes. We hope this research will assist in improving the age disparity in vulnerability to the disease COVID-19 during the pandemic.Keywords: COVID-19, SARS-CoV-2, coronavirus, infection, pandemic, deficiency, health, nutrition, immunity, diet, elderly, aging, senior citizens

Age Disparity in Marriage and Sexually Transmitted infections among Women in Shomolu Lagos State, Nigeria

This study investigates age disparity in marriage and the incidence of sexually transmitted infections among spouses in Shomolu, Lagos State Nigeria.The study adopted a descriptive and cross-sectional design in which a multi-stage sampling method comprising cluster sampling, simple random sampling and the convenience sampling techniques were used to select 400 married women in Shomolu, Lagos State. A structured, close ended questionnaire was used in a researcher administered survey to elicit responses. Descriptive statistics and the Chi-square test guided data analysis. Data show a high prevalence of older male-younger female marriage (n=365; 93.5%) and older-women-younger-male marriage (n = 14; 3.7%). Some women (n=48; 13.8%) had ever been infected with STIs such as Gonorrhea (n = 31; 64.5%), syphilis (n = 14; 29.2%) and chlamydia (n = 3; 6.3%). There was a statistically significant association between age disparity (χ2 = 4.266; df = 1; p<0.05), polygamy (χ2 =4.308; df = 1; p<0.05) and incidence of STIs among spouses, particularly women in older women-younger male marriage.The corresponding consequences for increased incidence of STIs among women in older women-younger male relationships should underscore social interventions that might reduce the incidence and consequences of STIs among this population.